Failure rates are significantly higher following hysteroscopic sterilisation (HS), in a theatre or office setting, compared with laparoscopic sterilisation (LS), a study has found. A research group from Pittsburgh reviewed the literature and collated a number of studies from which data were extracted and analysed. All studies had to have a minimum of 50 subjects with follow-up for at least 12 months. No absolute figures were presented, only percentages. Figures for successful sterilisation at the first attempt were: 99%, 86% and 85% for LS, HS in theatre and HS in the office setting at three months and 99%, 88% and 87% respectively six months post-procedure. The respective figures at 12 months were 99%, 95% and 94%. However, the method by which some patients were eventually successfully sterilised was different from the method they chose initially. Although, some women elected to have a second HS attempt, 7.0% of patients who had had HS in theatre and 5.3% of those who had had HS in an office setting went on to have a laparoscopic procedure. Overall, 5% of patients declined any further sterilisation attempts. When best and worst case data were compared the difference in success rates at 12 months showed LS to outperform HS by 0.4-10%.